Active NPI
Maxwell Osmen, PHARMD
- Pharmacist
- Lyons, NY
National Provider Identifier
1669855904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- I060452-1
- Practice address
- 20 Forgham St
Lyons, NY 14489 - Phone
- (315) 946-6699
- NPI assigned
- Jul 6, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | I060452-1 | NY | Primary |
Addresses
Primary practice location
20 Forgham St
Lyons, NY 14489
Mailing address
131 Bartle Ave
Newark, NY 14513-2101
Phone (315) 871-8689
Other practice location 1
20 Forgham St
Lyons, NY 14489
Phone (315) 946-6699
Other practice location 2
20 Forgham St
Lyons, NY 14489
Phone (315) 946-6699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| I060452-1 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| KPH Healthcare Services, Inc. | Past | Accepting new patients | |
| KPH Healthcare Services, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Lyons, NY
- NPI 1104933381
-
- Community/Retail Pharmacy
- Brattleboro, VT
- NPI 1407747157
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1669855904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "131 BARTLE AVE",
"city": "NEWARK",
"state": "NY",
"postal_code": "145132101",
"telephone_number": "315-871-8689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 FORGHAM ST",
"city": "LYONS",
"state": "NY",
"postal_code": "14489",
"telephone_number": "315-946-6699"
}
],
"practiceLocations": [
{
"address_1": "20 Forgham St",
"address_purpose": "LOCATION",
"city": "Lyons",
"state": "NY",
"postal_code": "14489",
"country_code": "US",
"telephone_number": "315-946-6699",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "20 Forgham St",
"address_purpose": "LOCATION",
"city": "Lyons",
"state": "NY",
"postal_code": "14489",
"country_code": "US",
"telephone_number": "315-946-6699",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "OSMEN",
"first_name": "MAXWELL",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-06",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "I060452-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lyons, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.